“Patient engagement” in health research — the meaningful and active involvement of patients in: the governance; priority setting; conducting; and translation of research — has received growing international recognition in recent years. This manuscript reviews some current concepts and practices in “patient engagement” and challenges readers to expand on status quo thinking and practices in pursuit of a more inclusive paradigm. For example, we support using the term “public engagement,” which takes into account myriad social identities that shape peoples’ experiences. We also argue for the need to recognize the role of trauma in peoples’ lives and how it can influence the nature of involvement in research. For this purpose, the article proposes incorporating a trauma-informed intersectional analysis into the public engagement approach in health research.

Health researchers are often charged with leading knowledge translation (KT) efforts. However, many lack the training and skills to do so, and there is a noted skepticism about the value of KT, reflecting a lack of cohesion between knowledge producers and knowledge users. Compared to other KT stakeholders (such as policy-makers and clinicians), the perspectives of researchers are under-studied. Filling this gap, the article explores experiences of KT practice among health researchers in Manitoba, Canada. Based on semi-structured interviews with 26 health researchers in Manitoba across all pillars of health research, distinctly varied conceptualizations of KT were identified along with a myriad of individual, logistic and systemic facilitators and barriers to practicing KT. While the conceptualization of KT varied across researchers and the four health research pillars, there was unanimity among researchers on the need for more individual and systemic support to practice KT.

Assessing balance with valid and comprehensive measures is necessary for children’s safe mobility and independence with functional tasks. However, current balance measures validated in pediatric populations lack comprehensive assessment of standing postural and exclude important components for safe mobility and independence. Comprehensively reviewing 21 identified validated balance measures used in pediatric populations between 1990 and 2015, this article finds that none of the identified measures were comprehensive to assess all components of balance. One key component of balance found to be not assessed in any measure was reactive postural control – the neuromuscular corrective response essential for fall avoidance. We highlight the need for continued work to identify and validate a comprehensive balance assessment that include all components of balance in pediatric populations.

(2016) Journal of Neurologic Physical Therapy – Sibley et al. Development of a Theory-Based Intervention to Increase Clinical Measurement of Reactive Balance in Adults at Risk of Falls: A Case Report (PubMed)

Use of theory in design of interventions is argued to increase impact and generalizability, but this needs to be tested in practice. Adding to data on the effectiveness of theory-informed behavior interventions, this article combines our previous KT research findings on barriers and facilitators in balance assessment and scoping review results with the Theoretical Domains Framework (TDF), a behavior change theory focused specifically on health care providers. While the study is ongoing, the development of the intervention itself was a major conceptual undertaking and is of practical value to researchers wishing to develop interventions in a similar manner. If successful, the intervention will remove a longstanding gap in the conceptualization and assessment of balance by physiotherapists that has a key relationship to falls and their associated consequences among older adult and rehabilitation populations.

This publication makes a major advance in promoting knowledge synthesis in the context of KT by responding to calls in the literature for more consistent measurement practices in clinical trials for comparison of individual studies. In particular, this work addresses gaps in the synthesis of exercise interventions for fall prevention and mobility. This consensus-seeking project describes the first attempt in the field of balance and mobility research to make recommendations for a minimum core outcome set (COS) of measurements to use when evaluating balance in older adults. An international panel of academic and clinical experts in the fields of balance, mobility, and fall prevention participated in a multi-stage consensus process that considered 66 measures, and recommended two as appropriate and feasible in a wide range of populations, research and practice settings.

The ability to maintain upright balance is a major factor in avoiding falls. However, evaluation of the effects of balance interventions to date has been hampered by a plethora of outcome measures, limiting the capacity for pooling data in meta-analyses. Knowledge synthesis, which synthesizes individual research studies and interprets the results within the context of global evidence, is regarded as the fundamental unit of KT. This publication illustrates an important application of KT methodology in an applied health context, reporting the results of a large scoping review. This work revealed key conceptual gaps in many existing balance measures, and as such, users may be missing critical information needed to design optimal fall prevention exercise programs.

This concept paper provides a description and analysis of the process of systematically applying the highly-cited Knowledge-to-Action (KTA) theory to research programs focused on balance and gait assessment in physical therapy practice. The use of the KTA framework to direct and shape a series of research questions a priori (as opposed to a traditional exploratory approach) is novel and uncommon. This publication is a KT dissemination strategy targeted to physical therapy and rehabilitation researchers about how to apply KT science in their research programs. The article advances KT science by critiquing the application of the KTA Framework in practice and describes how it needs to modified and tailored for different research settings.